IPAS Training – Maternal Health and Access to Safe Abortion

This last week, I, along with three of my amazing RA’s and our lovely LRA Kelly Thompson, got the opportunity to attend a training of trainers on the topic of maternal health and access to safe abortion, hosted by the organization Ipas in Chapel Hill, North Carolina. The training was part of a Memorandum of Understanding between Ipas and IFMSA, to hold trainings on these issues in three of our regions in IFMSA: Africa, EMR, and PAMSA. The training lasted for four days and I must say was one of the best trainings I have had the honor of attending in all my time in IFMSA, and here’s why.

  The topic of safe abortion is not one to be taken lightly. For many people, it brings up a lot of ethical and religious issues. And way too often we choose to not even speak about it instead of treating it as a common medical procedure. So common in fact that 1 in every 3 women in the US will have such a procedure at least once in their lifetime. Not only that, in 2008, 22 million women underwent an unsafe abortion with a reported 47,000 deaths and 5 million women suffering from disabilities. The problem is real and the fact is that it is 100% preventable. By providing proper safe abortion procedures, these women can be saved.   And it all starts with opening a discussion. So that’s exactly what we did, for four days we discussed with the amazing people at Ipas how we can best give a workshop about safe abortion within the IFMSA. And I must say that I was very impressed with the results and couldn’t be more excited to see the outcomes of these three pre-RM workshops. Ipas is an organization with more than 40 years experience in the field of maternal heath and safe abortion and they work on the ground in almost every continent. They face challenges and stigmatization every day to make sure that any woman who wants such a procedure can get it done in a safe and healthy environment. Their work is utterly inspiring and am so excited that we get to embark on this joint venture with them. Furthermore, the outcomes of these workshops will be used to finalize a joint training guide between Ipas and IFMSA SCORA!So I encourage anyone who is interested in working on this issue to please attend the RM workshops. And for those of you unable to attend a RM, then we will for sure be discussing this more within the upcoming March Meeting in Tunisia!

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World AIDS Day 2013

World AIDS Day 2013 Statement

 

Dearest SCORAngels,

Today is December 1st, 2013 and today as many of you know is World AIDS Day!

This year’s World AIDS Day finds many reasons for us to celebrate. New HIV infections have decreased 33% since 2001 with a 52% decrease amongst children and a decrease in 50% or more new cases amongst adults and adolescents in 26 countries around the world.  Furthermore, we are getting closer and closer to ensuring that 15 million people living with HIV/AIDS attain their necessary treatments by 2015. And most importantly, AIDS related deaths have dropped 30% since their peak in 2005.

And while this is all great news, there is still much work to be done! In many regions in the world, there is still barely any data about the amount of HIV positive individuals or transmission. In some cases, the data is so skewed that it doesn’t even make sense! Many people aren’t getting tested because they often think, “Oh that could never happen to me!” or “That only happens to people who sleep around or the gays.”

We’ve moved far from the days in which HIV was known as Gay Related Immunodeficiency Disease (or GRID); however, HIV related discrimination is still very prominent. People can still lose their jobs for being HIV positive and in some cases aren’t allowed to enter a country at all due to the HIV status. People living with HIV/AIDS are still being referred to as the “HIV positive patient” in our hospitals, regardless of their chief complaint. They are still harassed to find out how they got the virus and too often it is said that they “deserve it” for their behavior.

Regardless of who, what, how, why, and when, a person living with HIV/AIDS is still a person who deserves the rights and respect that should be given to every person on this earth. For at the end of the day, all that separates him or her from the rest of society is a virus that happens to be transmitted via blood or sexual contact.

I often find myself asking, why is this virus so different from the rest of those viruses and bacteria that are transmitted in similar ways? Is it because there is no cure yet? Is it because of the people it affected most first? Either way, the facts are there, that in this day in age, it is a tolerable disease, which if treated properly, can lead to a long and healthy life. And the only cure we really have is prevention.

And that is where we come in. On this day SCORAngels, I want you to wear your red ribbon proudly and I want you to walk through the streets, spreading this message: that HIV is here, it’s everywhere, and everyone should do their part to help out, not through stigmatizing and discriminating, but through showing care and compassion. Ignorance only causes harm but knowledge is power, and knowledge leads to a more tolerant and accepting society.

Throughout my 4 years in SCORA, I have and the opportunity to participate in 4 World AIDS Day events in my NMO in Lebanon. And each year it is remarkable how drastic the shift in public opinion is. Each year, we see less and less derogatory statements and each year the number of people who actively listen and thank us for what we are doing increases. The evidence is there people, we are making a difference, and even if you manage to change only one person’s opinion, that’s one more person on our side.

So SCORAngels, keep doing everything that you’re doing. Keep pushing hard to make changes in your communities. Keep fundraising for people living with HIV/AIDS. Keep handing out condoms on busy streets and in your colleges. Keep giving out free hugs and giving talks about safe sex practices. Keep posting pictures of you forming giant red ribbons and flashmobs. Keep telling people to test themselves as well as their sexual partners. Keep making a change and let’s make sure we “Get to Zero” sooner rather than later. And like I said, make sure to wear your red ribbons proudly and start the conversation, because if we don’t, no one else will.

With lots of SCORA love,

Joe Cherabie

Director on Reproductive health and HIV/AIDS

Medical Students on the Declaration of Helsinki and Human Research Subjects

Declaration of Helsinki

The World Medical Association (WMA) has developed the Declaration of Helsinki as a statement of ethical principles for medical research involving human subjects, including research on identifiable human material and data. It was first adopted at the 18th WMA General Assembly, Helsinki, Finland, June 1964 and last revised at the 59th WMA General Assembly, Seoul, October 2008.

The comments received during the pubic consultation process may be viewed at the following link: Click here to view DoH Public consultation 2013_submissions.

Dr. Margaret (Pres-Elect of WMA) and Dr. Kloiber  (Secretary) and Roopa Dhatt (IFMSA President)

IFMSA had the opportunity to participate in the final consultation in Washington D.C.  on August 26th 2013 hosted by the American Medical Association (AMA) at the Jay Adams Historical Hotel—where stakeholders discussed key aspects of this document. Once adopted the Declaration of Helsinki at the next WMA GA will set the new standards of medical research around the globe.

Comments

There was significant input from the U.S., Germany, United Kingdom, Brazil and Japan constituencies—as well as engagement from WHO and PAHO, and academics on both content and the specific language. Interestingly, consensus was reached on many areas of the draft document, but a fundamental debate existed about whether the declaration should be aspirational or should strive to be more pragmatic, similarly, there was clear notion that double standards should not exist in research practices around the globe.   Other areas that continued to spark controversial debate included the use of “placebo” in trial and justification of such usage.  As well, as whether the document should have greater flexibility or whether the document should be “stricter”—with requiring specific recommendations to be “must” versus “should.” Other hot points were on reporting of research trials–content of the reporting and making it mandatory.  Dr. Otmar Kloiber stated a strong position about open access to research and that all findings should be reported and made available–the outcomes and the lack of outcomes.

Roopa Dhatt, “Apple,” Dr. Mukesh, Ian and Xaiver

IFMSA representing a younger voice in the room brought attention to an area that was not explicitly stated in the section of Confidentiality, Privacy and Consent:

Special attention must be given to the storage of personal information on digital platforms. This information must be encrypted to ensure the privacy of the research subjects and only available to the responsible of the study.

(Consideration of social media is applicable to digital platform use).

Rationale: Every day, more patients’ data is being stored on digital platforms. These digital platforms exist in hospitals, schools, research institutions and many others. Any access to the platforms is a breach of privacy and violation of the rights of research subjects.  The system must be encrypted and ensure that only the responsible for the research is accessing that data. This a position that that Dr. Saxena from the WHO, Ethics department, also supported.

While the argument of including nitty-gritty details is valid for many aspects of the document, in our opinion, digital platforms are a reality of medical research and care–and often the principles of confidentiality, privacy & consent are not implemented in the case of digital data, especially when looking beyond clinical trials and health systems research.

As for social media, while it might not be necessary to explicitly included in the #DOH, it is still an area that requires consideration in the areas of medical research.  Please refer to a recent policy statement IFMSA passed built upon principles of HIPAA.

Global Health Information Privacy and Protection Statement (GHIPPS):

http://www.ifmsa.org/content/download/202203/2210099/file/2013MMPS_07-Global%20Health%20Information%20Privacy%20and%20Protection%20(GHIPPS).pdf.

Overall, the discussions were fruitful and led to not only space for voicing out opinions, but healthy dialogue among differing opinions, as well as a clear understanding of the drafting committee position.  The consultation demonstrated that this was an inclusive, open process. It was also apparent that the 150 inputs that were submitted were considered by the drafting committee and there was significant effort placed in improving the style, structure, content of the document to create a sound declaration for years to come.

WMA, JDN, IFMSA

The consultation ended with a splendid dinner bringing a wonderful closure to the meeting at the historic hotel! As well it was great to meet our Junior Doctors’ Network (JDN) colleagues at the meeting–as they provided continued support for the involvement of young people in the global decision making process.